Wound dehiscence is a typical complication of surgical wounds that involves the opening up of a surgical incision throughout the suture. In most instances, the sutures or closures around the wound perimeters must stay intact while new tissue starts to form to heal the wound. Nevertheless, once wound dehiscence occurs, the borders separate and the wound reopens instead of closing as intended.
What are the causes?
Wound dehiscence can be brought about by incorrect surgical procedures such as incorrect suturing, close-fitting sutures or using the unsuitable type of sutures. It can also be caused by increased stress to the wound as a result of heavy lifting, strenuous exercise, laughing, coughing, sneezing, straining during bowel movement or vomiting.
In some instances, wound dehiscence might be secondary to infection or poor healing as seen among those with chronic conditions, weak immune systems or malnutrition. If secondary in nature, it occurs among those with AIDS, diabetes, renal disease and those under radiotherapy or chemotherapy.
What are the types?
- Partial – only the superficial layers or part of the tissue layers reopen
- Complete – all the layers of the wound are separated which reveals the underlying tissue and organs that might even protrude out of the separated wound
What are the indications?
The signs and symptoms of wound dehiscence are evident and easy to identify such as the following:
- Open wound
- Broken sutures
- Pain at the wound site
- Drainage of pus or frothy liquid
All cases of wound dehiscence are considered as surgical emergencies that necessitate immediate attention. It is important to note that wound dehiscence is managed as a fresh wound and the surgical history of the wound is considered.
Antibiotic therapy is utilized to deal with any current infection that might be responsible for the dehiscence. Antibiotics can be used to prevent any future infections if none were present since dehiscence increases the risk for infection.
Surgical debridement is usually carried out to manage wound dehiscence by removal of the dead or infected tissue to allow better healing of the wound. The next step involves proper closure using the appropriate surgical technique and sutures. Lastly, the wound is closely observed to avoid dehiscence from recurring.
Regular changing of the dressings is required to minimize the risk for infection while at the same time, allowing exposure to the air to promote faster healing of the wound.